• Journal of Chest Surgery
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• 제18권4호
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• pp.806-811
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• 1985

Pulmonary arteriovenous fistula is a rare congenital vascular malformation in the lung, resulting from erroneous capillary development, with incomplete formation or disintegration of the vascular septa that would normally divide the primitive connection between the venous and arterial plexus. The pathogenesis of its symptom is that unoxygenated and desaturated arterial blood enter into the pulmonary venous system directly. Recently we have experienced a case of multiple pulmonary arteriovenous fistula in a 15 year old male patient, who presented the symptom of cyanosis and dyspnea on exertion. The operation revealed well circumscribed and multilobulated aneurysmal lesion in left lower lobe with its subpleural and posterolateral basal location, and another aneurysmal lesion in inferior lingular segment of left lung. There was no abnormal connection between the fistula and systemic circulation. The left lower lobectomy was performed along with local extirpation of the inferior lingular segment of left lung. Both lesions showed angiomatous dilatation of the various sized vessels embedded in the parenchyma microscopically. Postoperative clinical course disclosed much improvement in symptoms and in the value of blood gas analysis. The patient was discharged without any complication.

• Journal of Chest Surgery
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• 제27권5호
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• pp.399-401
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• 1994

We experienced one case of surgical treatment of A-V fistula between the right common iliac artery and the right common iliac vein after lumbar laminectomy. The average vascular surgeon does not have extensive experience with this disorder owing to its rarity. Arteriovenous fistula of the aorta and its major branches present an unparalleled challenge in patient care. Because of their central location, blood flow through these fistulas may be massive;the associated complications are usually dramatic, resulting in severe refractory congestive heart failure, massive venous hypertension, or extensive hemorrhage during an illfated surgical repair.For this reason, it behooves one to become well acquainted with the problem in order to avoid morbid complications and thus ensure optimal patient care.

• 한국병원경영학회지
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• 제26권2호
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• pp.17-26
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• 2021

Purposes: This study aims to identify factors affecting dental university hospitals' profitability and understand recent their business condition. Methodology: Data from 2016 to 2019 was collected from financial statement, public open data in 8 dental university hospitals. For the study, multiple regression test with stepwise selection was applied. Findings: First of all, 9 out of 19 independent variables were selected by stepwise selection. As a result of multiple regression test with selected independent variables and the dependent variable(operating profit margin ratio), the factors affecting hospitals' profitability were the number of dental unit chair, hospital location, debt ratio, total capital turnover ratio, employment cost rate, material cost rate, management expense rate, the number of patient per a dentist. Practical Implication: To improve dental university hospitals' profitability, hospitals specifically analysis and manage their cost such as employment, material and management cost and seek effectiveness by managing the proper number of patient per a dentist.

• Asian Journal of Innovation and Policy
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• 제8권1호
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• pp.122-140
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• 2019

Providing free primary care to everyone is an important goal pursued by many countries under universal health care programs. Countries like India need to efficiently utilize their limited capacities towards this purpose. Unfortunately, due to a variety of reasons, patients incur substantial travel and out-of-pocket expenses for getting primary care from publicly-funded facilities. We propose a set-covering optimization model to assist health policy-makers in managing existing capacity in a better way. Decision-making should consider upgrading centers with better potential to reduce patient expenses and reallocating capacities from less preferred facilities. A multinomial logit choice model is used to predict the preferences. In this article, a brief background and literature survey along with the mixed integer linear programming (MILP) optimization model are presented. The working of the model is illustrated with the help of numerical experiments.

• Journal of Korean Neurosurgical Society
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• 제65권4호
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• pp.603-608
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• 2022

Vertebral artery (VA) occlusion is frequently encountered, usually without acute ischemic injury of the brain. However, when it is accompanied by hypoplasia or stenosis of the opposite VA, brain ischemia may develop due to insufficient collateral supply. Both hemodynamic instability and embolic infarction can occur in VA occlusion, which may cause severe symptoms in a patient. Extracranial carotid-VA bypass should be considered for symptomatic VA occlusion patients, especially when the patient has repeated ischemic brain injuries. In this report, the cases of three extracranial carotid-VA bypass patients are introduced, along with a brief description of the surgical techniques. All three cases were treated with different bypass methods according to their disease location.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup2호
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• pp.11-18
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• 2008

소아의 급성 복통은 많은 환자들이 복통의 성격에 대해 적절히 표현하지 못하므로 진단에 어려움을 겪는 경우가 많다. 연령별 급성 복통의 원인들을 잘 숙지하고, 복통의 위치에 따른 진단적 접근을 시행한다. 가장 우선적으로 외과적 복통 여부를 가능한 빠른 시간 내에 감별해야 하며, 다음으로 장 폐쇄, 궤양성 질환, 간담도계 질환 등을 확인해야 한다. 이 때 주의해야 할 것은, 환자의 복통이 완전히 좋아질 때까지 반복적인 문진과 진찰을 게을리 하지 않아야 하는 것이다. 이렇게 함으로써 진단이 지연되거나 피할 수 없는 오진으로 인해 발생하는 환자의 고통을 최소한으로 줄일 수 있을 것이다. 끝으로, 지금까지 금기시 해왔던 급성 복통 환아들에 대한 통증 치료에 대한 인식의 전환이 필요한 때이다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2669-2673
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• 2014

Aim: To evaluate the predominant colorectal polyps in the Almadinah region of Saudi Arabia. Materials and Methods: In this iretrospective study, we analyzed pathology reports of colonoscopies performed in King Fahad Hospital, Madinah, Saudi Arabia during the period 2006 to 2013. Data based on patient age, gender, size, site and type of polyps and the degree of dysplasia were analyzed by software SPSS 17 and compared with other published studies from different geographic regions of the world. Results: During these years, 224 patients had colonic polyps, of whom 149 (66.5%) were men and 75 (33.5%) were women. The most common types of polyps were adenomatous (166), followed by hyperplastic polyps (24), juvenile (18), inflammatory (13), lipomatous (2) and one patient with Peutz-Jegher polyps. Tubulovillous adenoma was the commonest adenomatous polyp (102), followed by tubular (41) and villous (23) types. The sigmoid colon was the most commonly involved region (36.6%). Dysplasia was significantly associated with female patients who had large size tubulovillous polyps located in the left colon. Conclusions: The type and distribution of colorectal polyps in Saudi Arabia is very similar to Western countries. Patient gender, and size, histological type and location of polyps are closely related to dysplastic change in colonic polyps.

• 한국산학기술학회논문지
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• 제10권6호
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• pp.1256-1264
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• 2009

유비쿼터스 환경에서의 헬스케어 서비스는 환자의 의무기록 뿐 아니라 각종 검사 자료 등 환자에 대한 대부분의 정보를 데이터화 하게 되므로 인가되지 않은 시용자가 의료 시스템에 접근하여 의료 데이터를 원래의 목적과 다른 목적으로 사용하게 된다면 환자의 생명과 관련된 중요한 정보에 큰 위협을 가져올 수 있다. 따라서 이러한 문제를 해결하기 위해서 사용자의 위치나 시간과 같은 상황정보에 따른 접근제어가 가능하고 사용자의 프라이버시 보호를 가능하게 하는 RBAC for U-healthcare 모델을 설계하고 이를 구현함으로써 유비쿼터스 환경에서의 헬스케어를 위한 접근제어 모델의 유효성을 검증한다.

• Radiation Oncology Journal
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• 제35권1호
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• pp.1-15
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• 2017

Locoregional failure is the most frequent pattern of failure in locally advanced head and neck cancer patients and it leads to death in most of the patients. Second primary tumors occurring in the other head and neck region reach up to almost 40% of long-term survivors. Recommended and preferred retreatment option in operable patients is salvage surgical resection, reporting a 5-year overall survival of up to 40%. However, because of tumor location, extent, and underlying comorbidities, salvage surgery is often limited and compromised by incomplete resection. Reirradiation with or without combined chemotherapy is an appropriate option for unresectable recurrence. Reirradiation is carefully considered with a case-by-case basis. Reirradiation protocol enrollment is highly encouraged prior to committing patient to an aggressive therapy. Radiation doses greater than 60 Gy are usually recommended for successful salvage. Despite recent technical improvement in intensity-modulated radiotherapy (IMRT), the use of concurrent chemotherapy, and the emergence of molecularly targeted agents, careful patient selection remain as the most paramount factor in reirradiation. Tumors that recur or persist despite aggressive prior chemoradiation therapy imply the presence of chemoradio-resistant clonogens. Treatment protocols that combine novel targeted radiosensitizing agents with conformal high precision radiation are required to overcome the resistance while minimizing toxicity. Recent large number of data showed that IMRT may provide better locoregional control with acceptable acute or chronic morbidities. However, additional prospective studies are required before a definitive conclusion can be drawn on safety and effectiveness of IMRT.

• 한국응급구조학회지
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• 제18권1호
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• pp.7-15
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• 2014

Purpose: The purpose of the study is to evaluate the distance and location of the rescuer to patient for the effective chest compressions qualities. Methods: The subjects were 42 students who earned the basic lifesaving technique and had informed consents to participate in the study from May 1 to 20 in 2013. The position of the rescuers included model-0(reference point), model-1(10 cm distance), model-2(20 cm distance), and model-kn(kneeling up). Results: The mean depth of compression was $50.6{\pm}6.6mm$ in Model-0, $48.7{\pm}8.2mm$ in Model-1, $44.2{\pm}10.4mm$ in Model-2, and $51.8{\pm}6.0mm$ in Model-kn. There were statistically significant differences between each Model(p<.001). Conclusion: The closer distance between rescuer and patient could provide more effective chest compressions. Kneeling on the bed stance provided the deeper chest compression consistently than the stool stance.